What Is Childhood Asthma?

Childhood asthma, also known as paediatric asthma, shares similarities with the lung disease that affects adults. However, it often presents with distinct symptoms in children.

When a child has asthma, their respiratory system can become easily inflamed, particularly when exposed to factors like cold weather or allergens such as pollen. These symptoms can significantly disrupt their daily activities and sleep patterns, and in some cases, lead to hospitalisation due to asthma attacks.

While there is no cure for childhood asthma, collaborating with your child's healthcare provider is essential for managing the condition and minimising potential damage to their developing lungs.

Signs and Symptoms of Childhood Asthma

Asthma symptoms can vary from one child to another and may even change from episode to episode. Common signs and symptoms of childhood asthma include:

• A persistent cough may be the sole symptom.
• Frequent coughing episodes, especially during physical activities, exercise, nighttime, exposure to cold air, laughter, or crying.
• Exacerbation of cough following a viral infection.
• Reduced energy levels during play and the need to pause to catch their breath.
• Avoidance of sports or social activities.
• Sleep disturbances due to coughing or breathing difficulties.
• Rapid breathing.
• Chest tightness or discomfort.
• Audible wheezing sounds during inhalation or exhalation.
• Chest retractions are characterised by seesaw motions in the chest.
• Shortness of breath.
• Tension in the neck and chest muscles.
• Weakness or fatigue.
• Difficulty eating or grunting while feeding (common in infants).
• Any illness that interferes with a child's ability to breathe should prompt a medical evaluation by their doctor.

In the case of wheezing with shortness of breath or coughing in infants and toddlers, experts sometimes use the terms "reactive airway disease" and "bronchiolitis." Diagnosis of asthma in children under the age of 5 may be challenging using standard tests.

When to Seek Emergency Care

A severe asthma attack requires immediate medical attention. Watch for the following warning signs:

• Pausing in the middle of a sentence to catch a breath.
• Using abdominal muscles to breathe.
• The belly sinks under the ribs during attempts to breathe.
• Contraction of the chest and sides during breathing.
• Intense wheezing.
• Severe coughing.
• Difficulty walking or speaking.
• Bluish lips or fingernails.
• Increasing shortness of breath with decreased wheezing.
• Widened nostrils.
• Rapid heartbeat.
• Excessive sweating.
• Chest pain.

Causes and Triggers of Childhood Asthma

Common triggers for childhood asthma include:

• Airway infections such as colds, pneumonia, and sinus infections.
• Allergens like cockroaches, dust mites, mould, pet dander, and pollen.
• Irritants such as air pollution, chemicals, cold air, strong odours, or smoke.
• Physical exercise can lead to wheezing, coughing, and chest tightness.
• Stress may worsen breathing difficulties in children.

Diagnosis of Childhood Asthma

When your child presents with asthma-like symptoms, a comprehensive evaluation by their doctor is crucial. The diagnosis typically involves:

• In-depth questioning about their medical history and symptomatology, including any family history of asthma, allergies, eczema, or lung diseases.
• Physical examination, including listening to the heart and lungs and checking for signs of allergies in the nose or eyes.
• Specific tests, which may include a chest X-ray, spirometry (for children aged 6 and older), allergy skin testing, blood tests (IgE or RAST), and X-rays to identify sinus infections or gastroesophageal reflux disease (GERD) exacerbating asthma. Measurement of nitric oxide (eNO) in your child's breath can also indicate airway inflammation.

Childhood Asthma Treatment 

Based on the severity of your child's asthma and their medical history, the doctor will formulate an asthma action plan. This plan outlines when and how to administer asthma medications, how to respond to worsening symptoms, and when to seek emergency care. It's crucial to fully comprehend this plan and address any questions or concerns with your child's healthcare provider.

The asthma action plan plays a pivotal role in managing your child's asthma. Keep a copy readily available to remind you of the daily management regimen and to guide you when your child experiences asthma symptoms. Share copies with caregivers, teachers, and anyone responsible for your child when they are away from home.

In addition to adhering to the asthma action plan, it's essential to minimise your child's exposure to asthma triggers whenever possible.

Asthma Medications for Children

Most asthma medications suitable for adults and older children can be safely prescribed for toddlers and younger children. These drugs are administered in adjusted doses based on the child's age and weight. In the case of inhaled medications, a delivery device tailored to the child's age and ability may be necessary since many children cannot coordinate their breathing to use a standard inhaler effectively.

Asthma medications primarily fall into two categories:

1. Quick-relief medications: which provide rapid relief during asthma attacks.

2. Long-acting medications: These help prevent airway inflammation and maintain control over asthma. These are typically taken daily.

For infants and older children displaying asthma symptoms that require bronchodilator medication treatment more than twice a week during the day or more than twice a month at night, healthcare providers often recommend daily anti-inflammatory medications.

Many asthma medications contain steroids, which may have potential side effects, including irritation of the mouth and throat. Some research indicates that prolonged use might impact growth, cause bone issues, and lead to cataracts. Nevertheless, untreated asthma can result in health complications and hospitalizations. Therefore, it's essential to engage in a thorough discussion with your healthcare provider to weigh the benefits and drawbacks of medication when creating an asthma action plan for your child.